The American Sports Medicine Institute (ASMI) is a non-profit institute dedicated to the injury prevention, education and research in orthopaedic and sports medicine.

One of the co-founders of ASMI is Doctor James R. Andrews, a member of the Little League International Board of Directors and the person most responsible for bringing "pitch count" to Little League Baseball.

Doctor James R. Andrews is one of the founding members of Andrews Sports Medicine and Orthopaedic Center in Birmingham, Alabama.

• Co-founder of ASMI.
• Founding partner and Medical Director of the Andrews Institute in Gulf Breeze, Florida.
• Chairman of the Board of the Andrews Research and Education Foundation at the Andrews Institute.
• Member of the Little League International Board of Directors.
• Medical Director and Orthopaedic Surgeon for Auburn University Intercollegiate Athletics
• Senior Orthopaedic Consultant at the University of Alabama
• Medical and Safety Advisory Committee of USA Baseball
• Senior Consultant for the Washington Redskins Football team
• Orthopaedic Medical Director for the Tampa Bay Rays Baseball team
• Medical Director of the Ladies PGA

Doctor Andrews is known as a skilled orthopaedic surgeon as well as a scientific and clinical research specializing in knee, shoulder and elbow injury prevention and treatment.

His book, Any Given Monday, was written for athletes, parents and coaches and discusses sports injuries and how to prevent them.

The Number-one Risk of Arm Injuries Continues to be Year-round Play

Learn About Arm Safety Through Little League® and the Pitch Smart Program

Dr. Glenn Fleisig is the Research Director at ASMI. He is the recognized leader in baseball pitching biomechanics.

• Chair, USA Baseball Medical and Safety Committee
• Pitching Safety Consultant to Little League Baseball and Softball
• Injury Research Advisor, Major League Baseball

Dr. Fleisig was interviewed by Jonah Keri of Grantland Sports Podcasts regarding: The Tommy John Epidemic: What's Behind the Rapid Increase of Pitchers Undergoing Elbow Surgery? When asked about pitch counts, he said there are two mind-sets regarding pitch count, that of the pros and that of the amateurs. The mind-set of the pros is: "I'm a professional coach. I have a great job. Life is good. My job is to make sure no one gets hurt because I don't want to get fired." The mind-set of the amateur coach is: "I don't know what's gonna happen to this kid in 10 years, but I want him to help me win the championship this year."

Dr. Stan Conte, retired Medical Chief of the L.A. Dodgers presented the course on Injury Patterns in Baseball at the 2017 ASMI Conference.

He said injuries in MBL are increasing.

Fatigue is the number 1 cause of injuries in youth baseball.

• Pitches per inning, per season, per career
• Pitching in high stress innings
• Lack of rest between outings
• Increase or decrease in usage by year
• Number of pitching appearances
• Starter vs Reliever

Studies show

• Fewer pitch types in a pitcher's repertoire increases the risk factor for injuries
• Peak velocity of the fastball increases the risk of injury 

Dr. Steve Jordan, Orthopaedic Surgeon at Andrews Institute, discussed the Risk Factors in Youth Baseball Pitchers.

Generalizations:

• Overuse leads to later injuries
• Shoulder and elbow injuries account for 51% of pitcher injuries
• The percentage of High School players who play College Ball? 5.6%
• 60% of parents have never heard of pitch count
• 60% of coaches don't follow pitch count
• 30% of kids pitch on multiple teams
• Breakaway bases have shown a 98% reduction in sliding injuries

Risk Factors:

• Pitcher to Catcher
• Poor Mechanics
• Radar Guns - shown to have 4 times more risk of inury when radar guns are involved. Kids showing off and giving max effort
• Fatigue
• Specialization - 70-90% more likely to be injured

Suggestions:

• Follow the pitch count and rest between outings guidelines
• Avoid using the Curveball until old enough to shave
• The change-up reduces risk of injury by 33%
• No full-effort throwing for 4 months out of the year

Ron Wolforth, head trainter at the Texas Baseball Ranch discussed considerations beyond pitch count that youth coaches and parents should include in their vigilance to keep youth pitchers healthy.

Coaches should have a very frank discussion with athletes about PAIN. There are 4 reasons why youth lie about pain:

• Don't want to be seen as physically weak
• Don't want to be viewed as making excuses
• Afraid their playing time will be reduced if they go to the coach
• Afraid something might really be wrong

Pitches per inning are more important than pitches per outing. Use the "100 push-up" analagy: 10 push-ups and rest, 10 more push-ups and rest, etc. leaves the person feeling more fresh than performing all 100 push-ups at one time. At the Baseball Ranch, instructors use the following guidelines to determine when they should pull a pitcher:

• 12-18 pitches per inning is on schedule
• 19-24 pitches per inning if it occurs 3 innings in a game is a Yellow Light
• 25-30 pitches per inning if it occurs 2 times in a game is an Orange Light
• 31 or more pitches per inning is a Red Light - remove the pitcher

Pitching 40 pitches back-to-back as in showcases and travel ball lead to injuries.

Make sure the athlete stays hydrated, has plenty of rest and eats nutritious meals.